Information on the perceived difficulties in trying to eat a healthier diet is important in assisting those in nutrition education devise more effective programmes. The objective of this study was to determine the main perceived barriers that people have in trying to eat a healthy diet in the 15 member states of the European Union (EU). A cross-sectional study in which quota-controlled nationally representative samples of approximately 1000 adults (15 years upwards) from each member state completed a face-to-face interview-assisted questionnaire. The most frequently mentioned perceived barriers to healthy eating concerned time and taste factors. Time-related factors were more important for younger respondents and those with a higher level of education, who appear to regard taste as being compromised by healthy eating. Variation exists both between member states and between demographic groups in the frequency of barriers mentioned. A lack of knowledge about healthy eating was not selected by many as an important barrier. A major obstacle to nutrition education is the fact that 70 % of EU subjects believe their diets are already healthy. It may be that nutrition educators should concentrate on showing consumers how to evaluate their own diet appropriately in terms of fat, fibre, and fruit and vegetables. Food-based guidelines may be useful in this endeavour.

Objectives: To assess body image perception and satisfaction with current body image across the EU and to explore the influence of sociodemographic variables, body-weight change and strategies for losing weight on body image perception. Design: A cross-sectional study in which quota-controlled, nationally representative samples of approximately 1000 adults from each country completed a face-to-face interview-assisted questionnaire. Setting: The survey was conducted in the 15 member states of the EU between March and April 1997. Subjects: The questionnaire was completed by 15 239 subjects (aged 15 years and upwards). Data were weighted by population size for each country and by sex, age and regional distribution within each member state. Results: Just 39% of respondents in the EU were satisfied with their weight and these were more likely to be male (46%) rather than female (31%). Across the EU 29% of Finnish subjects were content with their weight compared with 47% in Belgium and 48% in Luxembourg. The highest percentage of subjects who were content with their body weight was among females who were underweight (58%) and males who were normal weight (66%). A further 20% of underweight females wished to be lighter compared to only 5% of males. Diet was the most frequently selected method for losing weight especially among females wishing to be considerably lighter (27%) while males were as likely to use exercise as diet as a strategy to lose weight. Conclusions: Geographical and sociodemographical influences on body image perception are evident across the EU. There were clear gender differences in the desire to be thinner with a high proportion of females who were underweight being content to be so.

Background: The WATCH IT programme was developed to address the needs of obese children from disadvantaged communities in Leeds and has been running since January 2004. Results of the pilot phase, prior to a randomised controlled trial, are presented. Methods: A process evaluation to assess success of implementation was conducted in December 2004. User views (parent and child) were obtained by semi-structured interviews and focus groups. Change in BMI SD score was calculated for children attending between January 2004 and November 2005. Results: A total of 94 children (49 girls, 45 boys), mean age (SD) 12.2 (2.0) years attended. They were moderately to severely obese (mean BMI SDS 3.09 (0.45), with low quality of life and self-image scores. There was a significant reduction in overweight at 6 months (DBMI SD 20.07), especially for teenagers (DBMI SD 20.13) and girls (DBMI SD 20.07). The programme was successfully implemented. By December 2004 mean attendance was 2.1 (0.7) clinics per month, and sports sessions 3.3 (1.7) sessions per month. Fourteen children dropped out and non-attendance was low (only 7.5% sessions missed in 12 months). Qualitative research indicated significant appreciation of the service, with reported increase in self-confidence and friendships, and reduction in self-harm. Conclusion: WATCH IT offers a model for a community based service for obese children. The programme suggests that effective care can be delivered by health trainers supervised by health professionals, and so potentially provides a cost effective programme within children's communities. These findings are encouraging, and need to be substantiated by extension to other locations and evaluation by randomised controlled trial.

Background/Objectives:Adequate protein intake is essential to retaining muscle and maintaining physical function, especially in the elderly, and L-Leucine has received attention as an essential amino acid (EAA) that enhances protein retention. The study's aim was to compare the efficacy of EAA mixtures on lean tissue mass (LTM) and functional performance (FP) in a healthy elderly population.Subjects/Methods:Thirty-six subjects (65–75 years) volunteered to receive capsules with EAAs (Groups A and B containing 20% and 40% L-Leucine, respectively) or placebo (lactose containing 0% L-Leucine, Group C) for 12 weeks. The daily amount ranged from 11 to 21 g (0.21 g/ kg/day) and was taken in two equal dosages alongside food, morning and evening. Main outcomes measured before and after intervention were LTM and FP (30-s arm-curl test; 30-s chair-stand test (30-CST); 6-min walk test (6-WT); and handgrip strength). Secondary outcomes included dietary intakes and physical activity.Results:Twenty-five subjects (11 male and 14 female) completed the study (Group A, n=8; Group B, n=8; Group C, n=9). Gains associated with medium effect sizes were noted in LTM (Group B, 1.1 ±1.1%, P=0.003) and FP (Group A in 30-CST (11.0±11.5%, P=0.02) and 6-WT (8.8±10.0%, P=0.02); Group B in 6-WT (5.8±6.6%, P=0.03) and a trend in 30-CST (13.2±16.0, P=0.06)). Significant differences between groups were not observed in secondary outcomes.Conclusions:Twice-daily supplementation of EAAs containing 20% or 40% L-Leucine improved aspects of functional status and at the higher level improved LTM. Further work to establish change in a larger sample and palatable supplemental format is now required.

Objective: The purpose of conducting this survey was to identify data on consumer attitudes towards and beliefs about physical activity, body weight and health among the 15 countries of the EU. Design: A cross-sectional study to get a picture of the attitudes to physical activity, body weight and health in the EU. For this, it was considered important that samples be nationally representative so that inferences drawn from the data could be applied to the population in each country as well as to the EU population as a whole. Using a non-probability sampling method employing quota controls (and the national weight) we obtained large sample sizes from each country which were nationally representative in terms of the variables age, sex and regional distribution. To ensure samples were truly nationally representative a national weight was used when analysing the data using the same characteristics as those used to define quotas. When examining pooled estimates for the total EU sample a population weight was applied. Results: In total, 15 239 subjects aged 15 years and upwards in the EU completed the survey. This article gives details on the methods used in carrying out the survey from design of the questionnaire to sample selection, questionnaire administration and analysis of the data. The methods and their limitations are discussed. Keywords Cross-sectional survey Sampling analysis European UnionThe purpose of conducting this survey was to identify data on consumer attitudes towards, and beliefs about, physical activity, body weight and health among the 15 countries of the EU. Data on the sociocultural and demographic differences in such attitudes will help those involved in the promotion of physical activity in the general population to develop more focused and effective campaigns. This article gives details on the methods used in carrying out the survey from the design of the questionnaire to sample selection, questionnaire administration and analysis of the data, all of which were similar to those used in an earlier pan-EU survey of consumer attitudes to food, nutrition and health 1 . Subsequent articles covering different issues from the survey will provide more details on the specific questions and their particular analyses. Questionnaire designA project management group developed the questionnaire. This group consisted of scientists from each member state and representatives from the food industry along with members of the Institute of European Food Studies (Appendix 1). A workshop was held to design the questionnaire firstly by reviewing existing studies on attitudes and secondly reviewing the methodology for measuring physical activity in large population surveys. The specific objectives of this pan-EU survey were as follows.X To identify the main attitudes to physical activity/ exercise, body weight and health in different countries in the EU and among different sociodemographic groups. X To examine the motivating factors and perceived barriers to participating in physical activity/exercise. X To d...

To increase the overall success rate of children's weight management interventions such as WATCH IT, current approaches to behaviour change may need to be adapted or tailored for those families who are less likely to be successful. Supporting overweight parents to make their own successful lifestyle changes may be one way of improving the child's likelihood of weight management success.

Background:  Current predictions suggest that by 2050 over half of the adult population will be classified as obese (Foresight Report, 2007). The media is a known platform for nutrition education and research indicates that health magazines specifically are highly influential in terms of their impact on health and diet (Hill, 2006). Although studies have examined the influence of magazine advertising on food choice, none have analysed the nutritional content of magazine diets in relation to healthy eating guidelines, or their influence over healthy dietary behaviours. The aim of this study was to identify whether the diets published in magazines adhere to national healthy eating guidelines as depicted by the Eatwell Plate (Food Standards Agency, 2007). Methods:  The 15 best selling diet and health magazines were identified from national sales data and purchased from a single retailer in December 2009, with the cost of each magazine noted. Inclusion criteria were defined as the presence of a health theme, target audience within 18–54 years and incorporation of a 7‐day diet plan. Diet plans were analysed using content analysis. Food lists were devised and coded through a deductive approach by cross referencing against the Eatwell Plate and previous content analysis studies. Associated word lists to determine subconscious influence were devised and coded using inductive content analysis. Each diet was analysed for food or word references, which were counted against the relevant codes. References were collated as a total across all magazines and presented as the number cited by category as a percentage of the total. Descriptive statistics were used to present the data. Ethical approval was gained fromLeeds Metropolitan University Research Ethics Committee. Results:  Ten magazines (seven aimed at women; three aimed at men) met the inclusion criteria, representing a full target age range and varied cost (£2.60 to £3.95). In total, 1155 food references and 266 word references were cited.Fruit and vegetables were referenced most frequently (37.7%), exceeding the Eatwell Plate recommendation (33.3%); carbohydrates were referenced poorly (20.5%), below the 33.3% recommendation; protein (22.3%) was above the 13% recommendation; dairy foods (13.5%) met the Eatwell Plate recommendation (13%). No magazine represented an accurate depiction of the Eatwell Plate model. The associated words attracting most references were for fluid (15%), fat (14.3%), protein (11.3%) and energy (10.5%), with protein referenced more often in men's magazines and calories more often in women's magazines. Discussion:  The lack of evidenced based and balanced dietary information in magazine diets was of concern and contradicted government health promotion strategies. The magazines promoted popular dietary trends as opposed to evidence based healthy eating guidance. The evident repetition of words relating to calories and fat does little to promote healthy dietary behaviours and little emphasis was placed on multicomponent dietary and lifestyle approach...

Background: Current predictions suggest that by 2050 over half of the adult population will be classified as obese (Foresight Report, 2007). The media is a known platform for nutrition education and research indicates that health magazines specifically are highly influential in terms of their impact on health and diet (Hill, 2006). Whilst studies have examined the influence of magazine advertising on food choice, none have analysed the nutritional content of magazine diets in relation to healthy eating guidelines, or their influence over healthy dietary behaviours. The aim of this study was to identify whether the diets published in magazines adhere to national healthy eating guidelines as depicted by the Eatwell Plate (Food Standards Agency, 2007). Methods: The 15 best selling diet and health magazines were identified from national sales data and purchased from a single retailer in December 2009, with the cost of each magazine noted. Inclusion criteria were defined as the presence of a health theme, target audience within 18-54 years and incorporation of a 7-day diet plan. Diet plans were analysed using content analysis. Food lists were devised and coded through a deductive approach by cross referencing against the Eatwell Plate and previous content analysis studies. Associated word lists to determine subconscious influence were devised and coded using inductive content analysis. Each diet was analysed for food or word references which were counted against the relevant codes. References were collated as a total across all magazines and presented as the number cited by category as a percentage of the total. Descriptive statistics were used to present the data. Ethical approval was gained from Leeds Metropolitan University Research Ethics Committee. Results: Ten magazines (seven women's; three men's) met the inclusion criteria, representing a full target age range and var-ied cost (£2.60-£3.95). In total 1155 food references and 266 word references were cited. Fruit and vegetables were referenced most frequently (37.7%), exceeding the Eatwell Plate recommendation (33.3%); carbohydrates were referenced poorly (20.5%), below the 33.3% recommendation; protein (22.3%) was above the 13% recommendation; dairy foods (13.5%) met the Eatwell Plate recommendation (13%). No magazine represented an accurate depiction of the Eatwell Plate model. The associated words attracting most references were for fluid (15%), fat (14.3%), protein (11.3%) and energy (10.5%) with protein referenced more often in men's magazines and calories more often in women's. Discussion: The lack of evidenced based and balanced dietary information in magazine diets was of concern and contradicted government health promotion strategies. The magazines promoted popular dietary trends as opposed to evidence based healthy eating guidance. The evident repetition of words relating to calories and fat does little to promote healthy dietary behaviours and little emphasis was placed on multi-component dietary and lifestyle approaches. Conclusion: The magazine die...